By Micah Katz, M.D.
Cayuga Medical Center surgeons have been performing robotic-assisted gallbladder surgeries using the da Vinci Surgical System since the fall of 2019. The robotic technology gives surgeons sophisticated tools that provide high magnification of the surgical site, greater surgical precision, and fluorescence imaging that offers visualization by activating injected dye to light up and clearly show the gallbladder and surrounding structures. Surgeons also use da Vinci technology for a variety of abdominal surgeries, including many types of hernia procedures, colon and small bowel surgery, bariatric surgery, and appendectomies.
Surgical removal of the gallbladder, also called a cholecystectomy, is a common treatment for gallstones and among the most frequently performed surgeries. Nearly 80 percent of gallbladder removals are now performed as minimally invasive surgeries, and an increasing number of surgeons are using robotic technology for the procedure.
When would gallbladder surgery benefit a patient?
Painful gallstones are the most frequent condition that results in gallbladder surgery. The gallbladder stores bile that is released into the intestine to help digest food. Several conditions can affect the gallbladder and cause gallstones to form. If a stone goes into, or blocks, one of the bile ducts it causes a “gallbladder attack,” an intense abdominal pain that can last several hours. This can progress to an infection, requiring urgent surgery. Any patients with gallstone-related symptoms are candidates for gallbladder surgery. Occasionally patients can have a dysfunctional gallbladder, called “biliary dyskinesia,” and they may also benefit from gallbladder surgery.
How do patients benefit from minimally invasive robotic surgery?
Minimally invasive surgeries result in less blood loss and faster recoveries, with most patients going home on the same day as the surgery and resuming their regular activities in a few weeks. An open gallbladder surgery, performed through a 6- to 8-inch incision, usually requires several days in the hospital for pain control and then a prolonged recovery.
Robotic-assisted surgery with a da Vinci system gives surgeons access to technology features that include:
- A high-definition 3D camera system with high magnification that provides immersive viewing of the gallbladder and surrounding area.
- Firefly fluorescence imaging that offers visualization using a dye to light up and clearly show the gallbladder and surrounding structures, including the ducts.
- Da Vinci technology allows surgeons to make small incisions, leading to less pain and improved cosmetic results.
What does the gallbladder do?
The gallbladder is a pear-shaped organ in the right upper abdomen just below the liver. It stores bile, which is a liquid produced in the liver. The gallbladder releases bile into the small bowel to help break down and absorb dietary fats. Normal digestion is possible without a gallbladder. Removal is a treatment option if the patient develops symptomatic stones, or the gallbladder becomes diseased or inflamed.
How does gallbladder removal affect a person?
Side effects after gallbladder removal are usually mild, but some patients experience diarrhea for a few weeks until their intestinal tract adjusts. Rarely, diarrhea can last for a longer period of time and needs to be treated with medications. After their surgeries, patients are encouraged to walk as soon as they’re awake and feeling better. Recovery back to usual activities takes around a week. Patients need to care for the incision wounds during their recovery by washing the area. Most people can shower the day after surgery. Stitches are generally below the skin and absorbable, so no sutures need to be removed at follow-up.
Dr. Katz received his medical degree from the University of Wisconsin School of Medicine and Public Health in Madison, WI. He did his general surgery training and residency at the University of Utah in Salt Lake City where he was also a fellow in the Center for Global Surgery. His fellowship research focused on expanding surgical capacity in Northern Ghana. His areas of special clinical experience include robotic-assisted surgery, gastroesophageal reflux/heartburn surgery, hernia surgery, and colorectal surgery.